多药耐药鲍氏不动杆菌β-内酰胺酶基因研究

β-Lactamase Genes of Multidrug Resistant Acinetobacter baumannii Isolates

目的对医院住院患者中分离的多药耐药鲍氏不动杆菌进行16种β-内酰胺酶基因携带状况的调查研究,以了解乌鲁木齐地区鲍氏不动杆菌多药耐药机制。方法采用ATB细菌鉴定仪系统鉴定分离菌株,根据CLSI的标准采用K-B法和微量稀释法测定抗菌药物的敏感性;最后采用聚合酶链反应检测16种β-内酰胺酶基因并在基因库上比对。结果耐药表型显示,多药耐药鲍氏不动杆菌对三代头孢噻肟和四环素耐药率最高,均达到100%,头孢派酮/舒巴坦等加酶抑制剂耐药率最低;20株多药耐药鲍氏不动杆菌中TEM型阳性5株(25%),OXA-23群阳性10株(50%),其余基因均阴性。结论乌鲁木齐地区鲍氏不动杆菌多药耐药率高;β-内酰胺酶基因携带情况主要集中在TEM型和OXA-23群;应进一步加强产β-内酰胺酶基因菌株的地方性流行病学监测。

OBJECTIVE To study the 16 genotypes of β-lactamase in multidrug-resistant Acinetobacter baurnannii isolated from inpatients, to know the state of multidrug resistance of A. baumannii in Urumqi. METHODS Bacterial strains were identified by system of API, and antibiotic susceptibility test was detected by K-B and microdilution according CLSI. PCR was used to determine the genotypes of β-lactamase and compare with that in GenBank. RESULTS The antibiotic resistance rates to cefataxime and tetracycline of the isolates were the highest, （100%）. Resistance rate to cefoperazone/sulbactam was the lowest （5 TEM （25%） strains and 10 OXA-23 strains （50%） from 20 strains multidrug resistant A. baumannii）. CONCLUSIONS There is a high percentage of multidrug resistance production of A. baumannii in Urumqi. The β-lactamase is focused on TEM and OXA-23 ; it is deserved to make further augmentation of epidemiology surveillance on β-lactamase.